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A substantial proportion of patients undergoing elective coronary artery bypass grafting have a history of paroxysmal atrial fibrillation. Paroxysmal atrial fibrillation has adverse short-and long term postoperative effects. Pulmonary vein isolation (PVI) seems to be effective treatment for paroxysmal atrial fibrillation. PVI can be done concomitantly with coronary artery bypass grafting, aortic valve replacement for aortic stenosis and combination of them. Procedure is well defined and safe.
There is a lack of convincing evidence of the effect on postoperative atrial fibrillation burden, quality of life and symptoms especially in correlation with atrial fibrillation paroxysms.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CABG, AVR or CABG+AVR and PVI | Experimental | Coronary artery bypass (CABG), aortic valve replacement for aortic stenosis (AVR) or combination (CABG+AVR) using cardio-pulmonary bypass (CBP) and occlusion. Concomitant pulmonary vein isolation (PVI) in CBP prior to occlusion and CABG |
|
| CABG, AVR or CABG+AVR | Active Comparator | Coronary artery bypass (CABG), aortic valve replacement for aortic stenosis(AVR) or combination(CABG+AVR) using cardio-pulmonary bypass (CBP) and occlusion. No operative procedures for the treatment of atrial fibrillation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CABG, AVR or CABG+AVR and PVI | Procedure |
| ||
| CABG, AVR or CABG+AVR |
| Measure | Description | Time Frame |
|---|---|---|
| Atrial fibrillation burden | Atrial fibrillation burden is defined as the amount of atrial fibrillation on one week Holter monitoring | Within one year after operative treatment |
| Freedom of symptomatic and asymptomatic atrial fibrillation after surgery | Atrial fibrillation is defined as atrial fibrillation paroxysm lasting at least 60 seconds. Freedom of atrial fibrillation is defined as duration of atrial fibrillation less than 0,5% of the one week Holter monitoring | Within one year after operative treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Compare quality of life (QOL) and symptoms, correlation of symptoms with atrial fibrillation | Within one year after operative treatment | |
| Adverse events after surgery in both arms | Within one year after operative treatment |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kuopio University Hospital | Kuopio | Eastern Finland | 70211 | Finland |
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| ID | Term |
|---|---|
| D001281 | Atrial Fibrillation |
| D003324 | Coronary Artery Disease |
| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
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| Procedure |
|
| Anti-arrhythmic treatment after surgery | Within one year after treatment |
| Hospitalization due to atrial fibrillation after surgery | Within one year after operative treatment |
| Cardioversion for the treatment of atrial fibrillation after surgery | Within one year after operative treatment |
| Other cardiovascular related events: death, stroke, cardiac infarction, need for revascularization and bleeding | Within one year after operative treatment |
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |